| NPI | 1710324108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6025) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 2270) |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2023-01-04 |